The Metabolic Classroom, Ep. 1: Intermittent Fasting

Summary

In this insightful discussion, experts delve into the effects of time-restricted eating on weight loss and metabolic health. They analyze two contrasting studies: one showing no significant benefits with a surprising loss of lean mass, and another with positive outcomes across various health metrics. The conversation highlights the importance of insulin control in conjunction with fasting, the role of individual response to dietary interventions, and the significance of an early eating window for better sleep and health outcomes.

Takeaways

• 🔬 The discussion revolves around two studies on time-restricted eating and its effects on weight loss and metabolic parameters in individuals with overweight and obesity.
• 📉 One study, published in the Journal of the American Medical Association, found no significant improvements with time-restricted eating, except for a concerning amount of lean mass loss.
• 📈 The other study, smaller in scale, reported positive outcomes across various health metrics, including fat loss and improved blood lipids, insulin, and glucose levels.
• 🧬 Randomization was a strength in one of the studies, aiming to eliminate inherent differences among participants, which is a common challenge in human studies compared to controlled rodent models.
• 🤔 There was a high dropout rate in the time-restricted eating group of the larger study, suggesting participants were reluctant to adhere to the fasting protocol.
• 🕒 The timing of the eating window varied between studies, with one ending at 8 p.m. and the other averaging last meals at 6 p.m., indicating the importance of considering meal timing relative to sleep.
• 🥗 Neither study provided specific dietary advice beyond the eating window, which could be a missed opportunity to combine time-restricted eating with macronutrient management for better outcomes.
• 🏋️‍♂️ The degree of lean mass loss reported in the larger study was unprecedented and may be an anomaly, suggesting the need for further research to confirm these findings.
• 🛑 The control group in the negative study was also an intervention, instructed to eat three consistent meals a day, which may not reflect typical eating habits and introduces a confounding variable.
• 💉 Insulin control was emphasized as a crucial factor in managing health and weight, with time-restricted eating being one of several tools to help achieve this, rather than a standalone solution.
• 🌟 Personal experience and intuition play a significant role in nutrition and health; individuals should not be discouraged by conflicting study results but instead focus on what works best for their unique circumstances.

Q & A

What is the main topic of discussion in the provided transcript?

The main topic of discussion is the effects of time-restricted eating on weight loss and other metabolic parameters, specifically in the context of two recently published studies with contrasting findings.

What is the difference between time-restricted eating and intermittent fasting?

Time-restricted eating refers to changing the eating window within a 24-hour period, whereas intermittent fasting involves fasting for a full day or more, with eating allowed on alternate days or following a specific pattern like 5-2 (five days eating, two days fasting).

What was the sample size of the randomized clinical study mentioned in the transcript?

The randomized clinical study mentioned in the transcript included well over a hundred participants.

What was the surprising finding in the study regarding weight loss and lean mass?

The surprising finding was that 65 percent of the weight loss in the time-restricted eating group was attributed to lean mass loss, which is unusually high and not consistent with other fasting studies.

Why might the high lean mass loss in the study be considered an anomaly?

The high lean mass loss might be considered an anomaly because it has not been observed in other studies of fasting, suggesting that it could be an artifact or due to a few individuals with an unusually high response.

What was the issue with the control group in the negative results study?

The issue with the control group was that they were also given an intervention, being told to eat three consistent meals a day, which is not a natural eating pattern for most people and could be seen as a confounding variable.

How did the participants in the study respond to being randomized into the time-restricted eating group?

The participants seemed reluctant to be randomized into the time-restricted eating group, as evidenced by a higher number of people being lost to follow-up in that group compared to the control group.

What is the significance of the eating window ending time in relation to sleep and health benefits?

The eating window ending time is significant because having a longer period between the last meal and bedtime can improve sleep quality and potentially lead to better health outcomes, as suggested by the positive results study.

What is the role of insulin control in the context of fasting and time-restricted eating?

Insulin control is considered a crucial factor in managing metabolism and weight. Combining time-restricted eating with strategies that lower insulin levels, such as controlling carbohydrates and prioritizing protein and fat, can enhance the benefits of fasting.

What advice do the experts give to individuals who are considering intermittent fasting?

The experts advise individuals to consider intermittent fasting as a tool and to apply it in a way that fits their lifestyle and intuition around hunger. They emphasize the importance of not suffering or being miserable with the approach and to prioritize insulin control.

What is the 'n equals one' concept mentioned by the participants?

The 'n equals one' concept refers to the idea that each individual's experience and response to a treatment or intervention is unique, making them their own study with a sample size of one, highlighting the importance of personal anecdotes and experiences.

Outlines

00:00

🔬 Controversy Over Time-Restricted Eating Study

The first paragraph introduces a discussion on a recent study about time-restricted eating, which is a form of fasting within a 24-hour window. The study, published in the Journal of the American Medical Association, is controversial due to its findings of no significant improvements in weight loss or other metabolic parameters for overweight and obese individuals. The study's randomized clinical trial design is highlighted as a strength, but concerns are raised about the high percentage of lean mass loss observed, which is unusual compared to other fasting studies. The paragraph also notes a high dropout rate in the time-restricted eating group, suggesting reluctance among participants.

05:02

📊 Contrasting Results in Time-Restricted Eating Research

The second paragraph compares the controversial study with another study published earlier in the year that reported positive outcomes for time-restricted eating, including improvements in fat loss, blood pressure, blood lipids, insulin, and glucose levels. This study was smaller and involved self-selected participants, suggesting a possible bias towards those already motivated for time-restricted eating. The discussion points out the lack of specific dietary advice in both studies, emphasizing the potential benefits of combining time-restricted eating with macronutrient management to lower insulin levels. The paragraph also notes the different eating windows in the studies and speculates on the impact of eating closer to bedtime.

10:04

🤔 Critique of Study Design and Control Groups

In the third paragraph, the critique of the negative study's design is expanded upon, with concerns about forcing participants into time-restricted eating and the artificial nature of the control group's instructions to eat three consistent meals a day. The discussion suggests that this control group setup could be a confounding variable, as it represents an intervention in itself. The paragraph also addresses the importance of an earlier eating window and the potential benefits of going to bed on an empty stomach, citing a study where an early 3 pm eating window ended positively.

15:05

🛠️ Intermittent Fasting as a Tool for Insulin Control

The fourth paragraph wraps up the discussion by emphasizing intermittent fasting as a tool for insulin control, rather than a one-size-fits-all solution. It highlights the importance of individual intuition and behavior around food, and the significance of controlling insulin levels for overall health. The speakers encourage not being discouraged by conflicting science and to focus on what works best for the individual, underscoring the 'n of one' concept, where personal experience is the most relevant study for oneself.

Keywords

💡Time-Restricted Eating

Time-restricted eating refers to a type of fasting where the consumption of food is limited to a specific time window within a 24-hour period. It is a dietary intervention that has been studied for its potential effects on weight loss and metabolic health. In the video, this concept is central to the discussion of a recent study's findings, where it was compared with other forms of fasting like alternate-day fasting and the 5:2 diet.

💡Randomized Clinical Study

A randomized clinical study is a type of scientific experiment where subjects are randomly assigned to different groups to eliminate biases and control for variables. The video discusses the strength of such a study design in the context of a recent research on time-restricted eating, emphasizing its power due to the randomization process that helps account for inherent human differences.

💡Lean Mass

Lean mass refers to the amount of muscle and other non-fat tissues in the body. In the video, it is highlighted that the study found a significant reduction in lean mass as a result of time-restricted eating, which is unusual and concerning because typically, weight loss efforts aim to minimize fat loss while preserving or increasing lean mass.

💡Insulin Resistance

Insulin resistance is a condition where the body's cells do not respond properly to the hormone insulin, leading to high blood sugar levels and potentially type 2 diabetes. The video discusses the importance of controlling insulin levels for overall health and how time-restricted eating can be a tool in managing insulin levels.

💡Intermittent Fasting

Intermittent fasting is an eating pattern that alternates between periods of eating and fasting. The video script discusses this as an alternative to daily calorie restriction, suggesting that it may have benefits such as improved metabolic health and weight loss. It contrasts with time-restricted eating in terms of the schedule and duration of fasting.

💡Lost to Follow-Up

In research, 'lost to follow-up' refers to participants who were initially enrolled in a study but were not available for subsequent data collection. The video mentions this as a potential issue in the study discussed, indicating that participants in the time-restricted eating group were reluctant and dropped out, which could affect the study's results.

💡Macronutrients

Macronutrients are the three main types of nutrients that provide energy: carbohydrates, proteins, and fats. The video script suggests that managing macronutrients, particularly controlling carbohydrates and prioritizing protein and fat, can complement the benefits of time-restricted eating by further lowering insulin levels.

💡Eating Window

The eating window refers to the specific hours during which an individual is allowed to consume food, as per time-restricted eating protocols. The video discusses how the timing of this window can impact the effectiveness of time-restricted eating, with earlier windows potentially being more beneficial.

💡Insulin IQ

Insulin IQ appears to be the platform or community where the video is being discussed. It seems to focus on science-based approaches to health, particularly related to insulin management. The term is used to refer to the audience and the educational mission of the platform.

💡N of 1

The term 'N of 1' refers to a single-subject research design or an individual's unique experience, emphasizing personal anecdotes and self-experimentation. In the video, it is used to highlight the importance of personal experience with intermittent fasting, suggesting that each person's response to dietary changes is unique and valuable.

Highlights

Discussion of a recent study on time-restricted eating and its effects on weight loss and metabolic parameters in overweight and obese individuals.

The study was a randomized clinical trial, which adds strength due to the elimination of inherent human variability.

The study found no significant improvements with time-restricted eating, contrary to expectations.

A significant reduction in weight was observed, but it was attributed to a loss of lean mass, not fat.

The degree of lean mass loss was unusually high at 65% of total weight lost, which is not consistent with other fasting studies.

Some individuals on social media are using this finding as a reason to avoid time-restricted eating due to concerns about muscle mass.

The study had a high dropout rate in the time-restricted eating group, with seven participants lost to follow-up.

Comparison with an earlier study that found numerous benefits from time-restricted eating, suggesting a possible selection bias in participant motivation.

Neither study provided specific dietary advice, only a time window for eating, which could be a common strength or weakness.

The importance of combining time-restricted eating with macronutrient management for potential synergistic effects.

The timing of the last meal in the studies may have affected results, with earlier meals potentially leading to better outcomes.

The control group in the negative study was also an intervention, which could have influenced the study's outcomes.

The potential impact of going to bed on an empty stomach on sleep quality and overall well-being.

The role of insulin control in the success of time-restricted eating and the importance of individualizing dietary approaches.

Intermittent fasting as a tool for insulin control, with case studies showing its effectiveness in type 2 diabetes management.

The significance of individual behavior and intuition in dietary practices and the importance of not suffering for the sake of a dietary protocol.

The value of understanding and applying the science of fasting and time-restricted eating in a practical, individualized manner.

Transcripts

we have a little bit of ben's science

corner yeah

what's with the big voice last time it

was then

we don't know what the call is the

classroom

the reason we want to take a few minutes

is because this week

dr sher brett sher

of diet doc referencing another

article that was published this past

week

and it started a conversation here at

insulin iq

and so ben thought that he might just

get with steve and rich

and spend a little time just talk about

this particular

article and dr shore's uh

comments on it yeah probably take a few

minutes to do that so i'll turn the time

over to ben

yeah yeah thanks thanks jack so you guys

this is something i thought might be fun

to do from time to time where we

i can pull out some relevant science

in the actual manuscripts that have been

published and just sort of give you guys

a bit of a primer on some of these

findings from time to time

so as jack highlighted this study came

out very recently about

fasting or time restricted eating that

form of fasting where

it's fasting within a 24-hour window so

i use the term time-restricted eating

to refer to that when you when you're

changing the eating window within a

24-hour window

rather than like alternate day or or you

know because

people can do a one-on-one fasting where

they eat one day fast another day or

they do a 5-2

let's call that intermittent fasting

where it's a full day

or so and then time-restricted eating

when it's within one day

journal the journal of the american

medical association one of the

preeminent biomedical journals

um the you'll see the link uh the boys

are gonna

i think post that that a picture of it

but the title

of this one that was just published the

effects of time restricted eating on

weight loss and other metabolic

parameters

in women and men with overweight and

obesity one of the strengths of this

study and they are they are

right to highlight this is that it was a

randomized

clinical study so that there's a power

there

because in randomizing it you're you're

hopefully

eliminating uh or accounting for some of

the inherent differences that people may

well that that we all have we're that's

the problem with studying humans why so

many of us rely on

on rodent models i can have a whole

colony of mice that are basically

genetically identical and are going to

respond to the diets and everything we

do identically

in humans of course we have such a

variety so it was a randomized

trial and and it was fairly big where

they were

they had well over a hundred people

included in the study that's

really good for a human study

one concern i had from the get-go with

the so so briefly this study finds

basically no

significant improvements with the

time-restricted eating just to kind of

cut to the

cut to the um outcomes or the results

they found

that there was a significant reduction

in weight

in the time-restricted eating group but

also a significant reduction in lean

mass

in fact it was a shocking amount i think

65 percent of the weight lost

was considered from lean mass and that i

say

shocking because it is a very high

degree of lean mass

loss it also is a lean mass loss that is

not seen in any other study of

of fasting to my knowledge so that was a

bit of an

a shocking finding and a bit of an

anomaly

now some people i've seen in social

media are citing that one finding as

reason

to avoid time-restricted eating because

they want to

get big with muscle mass gains or they

want to maintain muscle mass gains

i would simply try to alleviate that

concern by saying

that is not a finding seen in other

studies

so the degree to which that is is real

and i'm not accusing this

the authors of this manuscript in any

way of dishonesty no

it could just be an artifact it's

something that's come up and it's just

an anomaly

or there were a couple people that had a

very high response

and the rest didn't at all so whether

that's a real worry or not

i don't think it is just because it's

not been shown in other studies but

that's one of the key takeaways

from this sort of negative study if we

want to call it that

there was a significant body mass

reduction but it was not because of fat

loss based on how they measured this it

was because of a lean

a lean mass loss now one other problem

with this

recently published study this randomized

trial

people were reluctant it seems to be

randomized into the time restricted

eating group

into that fasting group and i say that

they were reluctant to get into that

group

because in the results they report

something called lost

to follow-up so people who committed to

study

and once they were randomized into the

two groups

and we'll emphasize another problem with

those two groups in a moment

the people that were randomized in the

time restricted eating group

they uh seven of them were lost to

follow up so they

were put into the group and then they

didn't want to do anything to do with it

and they then the researchers couldn't

contact them again seven people were

lost

from the fasting group only one was lost

from the control group so there's

something i think about people very

reluctantly being put into the fasting

group and they didn't want to

now with that point in mind i'll

emphasize the second study that was

published earlier this year

that found a legion of benefits every

outcome they looked at

with time-restricted eating they got

better

whether it was fat loss blood pressure

loss

blood lipid improvements insulin

improvements glucose improvements

and the boys will show that other study

here uh but here's the other one

here's the other one that i'm

emphasizing um and i'm just i think it's

interesting to compare these two

one both published this year um and have

very different findings

now this study which found significant

improvements across the board

it was much much smaller i think was it

19

people steve do you remember i think it

was 19 subjects

but they all were they all self-selected

in so this is basically a case study

where they had 19 patients

who wanted to engage in time-restricted

eating i think there's something

powerful to that

where this group of people in the

positive results study

they wanted to do time-restricted eating

they self-selected they volunteered they

wanted to do it

as opposed to the group that i believe

apparently were very reluctant

in so far as the loss to follow-up was

seven times higher

and ben weren't they just showing they

were not on a specific

dietary response they were just eating

whatever they wanted to eat right they

weren't eating an insulin controlled

diet or a ketogenic diet of any kind and

the time window

was like 10 hours wasn't it yes so

that's the next important that's another

point yeah

so what these studies both have in

common is that

neither gave specific dietary advice

beyond

here's your eating window stick to it so

that's a strength

that they both have in common but

it's a weakness that we would all agree

to if you're going to encourage someone

to time restricted eat to time

restricted eating or fasting

i think you really ought to be playing

with that other lever

which is arguably at least as relevant

which is manipulate

manage your macronutrients in a way that

if much of the power of time restricted

eating and fasting is that you lower

your insulin imagine if you can couple

the insulin lowering effective fasting

or time-restricted eating

with the insulin lowering effect of

controlling carbohydrates prioritizing

protein and filled with fat

so i do think there's a lot of synergy i

hate to use that word

because it's so cliche but there's a lot

of power in combining

time-restricted eating with manager

macronutrients

which they didn't do but that that's

okay because it allows us to compare

these two studies head to head

now rich you'd mentioned the eating

window i think that's another point to

mention

in the negative results study finding

nothing really beneficial about the

time-restricted eating

the the time of ending your diet the

food for the day was 8 p.m

as opposed to the positive finding their

at last meals

on average were at 6 p.m and they

actually measured that on average the

average subject

was eating their last calories four

hours before they were going to bed

and that wasn't they didn't report on

that in the negative results study and i

can't help but wonder

to what degree were the benefits

the positive study was the benefit

partly because they were sleeping better

which they did indicate as opposed to no

improvements in sleeping in the time

restricted eating study no longer window

after they finish eating

before that yeah more time for the food

to digest i worry if

these people in the negative results

study or anything like me they had to

fight the temptation to just binge all

evening

you know when suddenly they're home they

they are

they are you know that's quiet time the

day has slowed down they're ready to sit

down and

binge watch netflix and they're ready to

binge eat something they shouldn't

and they feel okay about it because it's

in their eating window and they weren't

told to restrict calories and that's

another point

in the negative results study there was

no difference in calories they were

eating the exact same amount of calories

as they were before the study started

that shouldn't be viewed as a weakness

because we don't tell people to control

calories with insulin iq education and i

don't think we ever should

but one of the things that just tends to

happen

is people just tend to start controlling

their calories a little better

that was evidenced in the positive

results study

they were eating just by self their own

will their own choice just by nature of

the eating window changing they were

eating about 10

10 fewer calories per day just of their

own volition i think there's

something meaningful there well and ben

involving people into a insulin

controlled protocol where they're eating

a little more fat protein and and the

windows a little more

like an 18-6 kind of window not i mean a

10-hour window of eating

that's big is that really fasting that's

big i know i mean i know

who eats more than 10 hours a day yeah

that's a small step i don't know how

they call that fasting

right yeah i think these are two that's

a day that ends with why

i think these are two completely

different studies and i think they

were set up completely differently uh

and you know

the uh the larger study the smaller

study was 19 people and they didn't

really have a control group

the larger study the control group was

told to eat three meals a day yeah

yeah i don't know many people that in a

in a measured period of time

actually get three separate meals a day

every day

and that may uh i think that's an

artificial uh element

involved in this study as well that they

are asked to eat three meals a day i

don't know how that

that came through an excellent point

yeah i'm glad you i meant to i wanted to

bring that up

so when they split these two groups in a

negative study they split them into two

groups the people randomized

um one was the time-restricted eating

the other one was

i believe just as much an intervention

where they were told you eat three

meals per day people don't do that

that alone is an intervention which i

think creates a bit of a confounding

variable

that if they had been told eat whatever

you want

you're the control group don't change

anything you eat what you're doing

and then maybe try to attempt um to

in the time restricted eating group kind

of try to calorie match them

which isn't some that's not easy to do

it is admittedly kind of next level

difficulty but

but in a rodent study when we do this

kinds of things in the perfectly

controlled environment of rodent work

we we will pair feed them we will say

okay the control group ate this much

we're going to try to help these other

animals eat this much same calorie

maybe it's a ketogenic diet or maybe

it's a narrowed eating window

or time-restricted eating but again one

of the problems with the negative

results study

is that the control group was just as

much of an intervention

they were told i believe in just as much

a way to

change their diet than the time

restricted eating group

because going to the average person and

telling them you need to eat three

what did they call them consistent meal

timing

so that was the group that was the

control group consistent meal timing

that's not how much that's not a

controller

that is a confounding variable that i

think was a bit of a problem

so those are some of the main concerns

with the negative results study

i think there's a problem in forcing

people to time restricted eat when they

don't want to

also i think the control group was a bit

problematic insofar as it

was as much an intervention as the

intervention group the fasting group

and in the time the eating window

actually ended up going pretty late into

the day

and i think it probably was pushing up

till bedtime a little too closely

and that would offset some of the

benefits now

another thing else in fact to emphasize

that point into these authors credit in

the negative study

they cite a study they cite one of the

concerns

in their negative findings could be that

the eating window was too late

that maybe if they pushed it into the

earlier in the day there could have been

a benefit and they cite a study

where the eating window ended at 3 pm

and

you know that's a wonderfully long

period of time before you go to bed and

i

the more the older i get and the more i

kind of manipulate my own

lifestyle the more power i see in my

life

of going to bed on a relatively empty

stomach i'm not going to bed hungry

but i'm not going to bed full that tim

that

in my as i'm in my mid 40s now is the

single greatest variable

on how well i sleep and how well i feel

the next day how energetic i am

don't go to bed full anyway there's some

thoughts

so what am i missing what else anything

to add on that steve well

i would just like to say what do you see

well physician

i agree a lot with with uh what you've

said dr bickman i

i just have to say in my practice i

don't

have any of my patients in this negative

finding study

follow this at all because as we

emphasize here it's about controlling

insulin and intermittent fasting

is one of the many tools that we have in

insulin control

is by far the most important factor to

focus on

and my patients that focus on insulin

control have tremendous success the ones

that combine

time restricted eating the having a six

or eight hour period a day

where they're focusing on controlling

insulin keeping it low

during that window combining those two

variables have tremendous success so

this is a very interesting study

that did not at all focus on insulin

control

and i think that's as far as i'm

concerned is the greatest variable that

didn't play out in this study it may

explain why they had a negative result

because that wasn't their that wasn't

their focus and controlling insulin

is the most important focus when you

look at your your nutrition

in fact speaking of controlling insulin

what i ought to have done is also bring

in the case studies that

dr jason fung has reported where they

find they take

profoundly insulin resistant type 2

diabetics that are on insulin therapy

they're that insulin resistant that they

need

more insulin to control their glucose

which is lots of patients which is

which is terrible but they find that

within just a couple weeks

the intermittent fasting is so effective

that they're able to get off all

insulin i find that as well with my type

2 diabetics insulin controlled

yeah within two weeks 20 years on

insulin they're off that's cs crazy

the power and benefit we're also talking

about behavior

here where where if somebody has the

will and

the ability to fast it's just that

they're so much more intuitive

around their eating patterns when

they're fasting they can feel when

they're hungry they're not

saying hey i gotta eat you know eight

and at 10 and at 12 and

they're starting to be way more

intuitive around their behavior around

food i just don't want him to get

discouraged if you have just discovered

this intermittent fasting tool remember

it's a tool

and you have to apply it to your

lifestyle and what works best for you i

think it's more important

that you're intuitive about your

nutrition and that you don't make

yourself

suffer because you're much more likely

to to not be consistent and not be

successful if you are

miserable with what you're doing i enjoy

the window of opportunity to eat and i

feel so much better going to bed on an

emptier stomach but boy let me tell you

there are times once in a while after if

i've worked out real hard i'm still

hungry

and i will still satisfy my hunger even

though it's a little outside the window

with my focus being insulin control

and that by far gives me the greater

benefit and for all my patients

i tell them that is your first focus is

keeping your insulin low the second one

is being intuitive about your hunger

so don't get discouraged by this study

it's an interesting study but

it no way reflects how i teach my

patients intermittent fasting is a tool

but it's not by any means the most

effective way to achieve

health by avoiding the plagues of

insulin resistance

great yeah yeah you guys let us know

what you think if this sort of

metabolic classroom um manuscript

discussion is

uh helpful uh then we'll keep doing them

because there are a lot of cool studies

we can get to in the future

yeah and studies can be very confusing

you need several of them to understand

what a real outcome is this other study

the positive one only had 19

participants

and they were very well controlled and

that's much more similar to how i wrote

my practice

so i see that this positive result study

is much more like

i see day in and day out in my practice

because

it's very controlled there's a specific

purpose the patients are well screened

they're motivated

and they're motivated and uh and

that's what we're here to do is to help

you see the motivation

thank you thanks for discussing that

it's important that our audience know

we know our audience at insulin iq we

have

very very science-focused folks

in the community that follow every

single bit of research that dr pickman

does

and then we have folks watching today

that are on the total

other end of the scale they're just

coming to this whole space

and and some of the things are just far

too deep and too technical

our mission is to try to take the

science and

dissect it and work it and we bash it

around

and spend a lot of time but then we try

to

condense it down and hone it in so that

we have

actionable things that insulin iq uh

clients and and students can do so steve

i appreciate that you

kind of brought that home with and you

too uh rich as far as behavior

and don't be discouraged about

intermittent fasting

don't think that because there is

conflicting science that

it we don't see a huge amount of

of patients and and students that we

help

and ultimately jack it's n equals one i

mean

how it affects you n equals one yeah

you're the study

you are the study you are the study yeah

so n in fact to be scientific

n refers to a sample size so this study

you know was an n of 19 or an n of 116

and this refers to the sample size so

rich's point

is that anecdotes matter that if you

yourself are seeing a benefit you are

conducting your own study in n of you

you're

your own sample size great so i said

something smart it was brilliant

brilliant tell your kids i know i hope

my kids are watching

i hope my wife's watching we're going to

transition to a few questions

and